Comparative Effectiveness of 2 Diabetes Prevention Lifestyle Programs in the Workplace: The City and County of San Francisco Diabetes Prevention Trial

Overview

Journal Prev Chronic Dis

Specialty Public Health

Date 2020 May 29

PMID 32463786

Citations 2

Authors

Assiamira Ferrara

Julia C McDonald

Susan D Brown

Janet G Alexander

Jennifer L Christian-Herman

Stephanie Fisher

Charles P Quesenberry

Affiliations

Soon will be listed here.

Abstract

Introduction: Data on the comparative effectiveness of Diabetes Prevention Programs (DPPs) in the workplace are limited.

Methods: Between September 2015 and July 2016, employees of the City and County of San Francisco who were at risk for type 2 diabetes (N = 158) were randomly assigned to one of 2 DPP-derived programs recognized by the Centers for Disease Control and Prevention: an in-person YMCA-DPP (n = 78) or an online virtual lifestyle management DPP (VLM-DPP) offered through Canary Health (n = 80). The primary outcome was change in body weight assessed at 6 and 12 months. Follow-up ended in August 2017.

Results: Both the YMCA-DPP and VLM-DPP yielded a significant reduction in percentage body weight at 6 months. For the YMCA-DPP, mean percentage change at 6 months was -2.70% (95% confidence interval [CI], -3.91% to -1.48%) and at 12 months was -2.46% (95% CI, -4.24% to -0.68%). For the VLM-DPP, mean percentage change at 6 months was -2.41% (95% CI, -4.07% to -0.77%) and at 12 months was -1.59% (95% CI, -3.51% to 0.33%). The mean between-condition difference at 6 months was -0.25% (95% CI, -2.04% to 1.55%) and at 12 months was -0.84% (95% CI, -3.03% to 1.34%). No significant differences were observed between conditions. The YMCA-DPP had a slightly higher reduction in waist circumference than VLM-DDP at 6 months (mean between-condition difference -2.00 cm [95% CI, -4.24 to 0.25 cm]). Participant engagement, expressed as mean number of completed core program sessions, was significantly higher for the YMCA-DPP than the VLM-DPP. Participants of the YMCA-DPP completed an average of 10.2 sessions (95% CI, 9.0 to 11.4), and participants of the VLM-DPP completed an average of 5.9 sessions (95% CI, 4.7 to 7.1). The adjusted mean between-condition difference was 4.2 sessions (95% CI, 2.54 to 5.99).

Conclusion: Both the YMCA-DPP and VLM-DPP yielded weight loss at 6 months, which was maintained at 12 months in the YMCA-DPP. The workplace may be an effective setting to offer DPPs.

Citing Articles

Twelve-Month Reach and Effectiveness of a University-Based Diabetes Prevention Initiative.

Gholami M, Jackson N, Loeb T, Chung U, Ramm K, Shedd K Am J Prev Med. 2023; 66(2):299-306.

PMID: 37741423 PMC: 10842474. DOI: 10.1016/j.amepre.2023.09.018.

A Pilot Study to Examine the Feasibility and Acceptability of a Virtual Adaptation of an In-Person Adolescent Diabetes Prevention Program.

Islam S, Elaiho C, Arniella G, Rivera S, Vangeepuram N Int J Environ Res Public Health. 2022; 19(19).

PMID: 36231588 PMC: 9564467. DOI: 10.3390/ijerph191912286.

References

Hamman R, Wing R, Edelstein S, Lachin J, Bray G, Delahanty L . Effect of weight loss with lifestyle intervention on risk of diabetes. Diabetes Care. 2006; 29(9):2102-7. PMC: 1762038. DOI: 10.2337/dc06-0560. View

Joiner K, Nam S, Whittemore R . Lifestyle interventions based on the diabetes prevention program delivered via eHealth: A systematic review and meta-analysis. Prev Med. 2017; 100:194-207. PMC: 5699208. DOI: 10.1016/j.ypmed.2017.04.033. View

Brown S, Garcia A, Zuniga J, Lewis K . Effectiveness of workplace diabetes prevention programs: A systematic review of the evidence. Patient Educ Couns. 2018; 101(6):1036-1050. DOI: 10.1016/j.pec.2018.01.001. View

Raab G, Day S, Sales J . How to select covariates to include in the analysis of a clinical trial. Control Clin Trials. 2000; 21(4):330-42. DOI: 10.1016/s0197-2456(00)00061-1. View

Aldana S, Barlow M, Smith R, Yanowitz F, Adams T, Loveday L . A worksite diabetes prevention program: two-year impact on employee health. AAOHN J. 2006; 54(9):389-95. DOI: 10.1177/216507990605400902. View

Narayan K, Boyle J, Thompson T, Sorensen S, Williamson D . Lifetime risk for diabetes mellitus in the United States. JAMA. 2003; 290(14):1884-90. DOI: 10.1001/jama.290.14.1884. View

Craig C, Marshall A, Sjostrom M, Bauman A, Booth M, Ainsworth B . International physical activity questionnaire: 12-country reliability and validity. Med Sci Sports Exerc. 2003; 35(8):1381-95. DOI: 10.1249/01.MSS.0000078924.61453.FB. View

Ali M, Echouffo-Tcheugui J, Williamson D . How effective were lifestyle interventions in real-world settings that were modeled on the Diabetes Prevention Program?. Health Aff (Millwood). 2012; 31(1):67-75. DOI: 10.1377/hlthaff.2011.1009. View

Kramer M, Molenaar D, Arena V, Venditti E, Meehan R, Miller R . Improving employee health: evaluation of a worksite lifestyle change program to decrease risk factors for diabetes and cardiovascular disease. J Occup Environ Med. 2015; 57(3):284-91. PMC: 4351781. DOI: 10.1097/JOM.0000000000000350. View

10.

Weinhold K, Miller C, Marrero D, Nagaraja H, Focht B, Gascon G . A Randomized Controlled Trial Translating the Diabetes Prevention Program to a University Worksite, Ohio, 2012-2014. Prev Chronic Dis. 2015; 12:E210. PMC: 4674443. DOI: 10.5888/pcd12.150301. View

11.

Hafez D, Fedewa A, Moran M, OBrien M, Ackermann R, Kullgren J . Workplace Interventions to Prevent Type 2 Diabetes Mellitus: a Narrative Review. Curr Diab Rep. 2017; 17(2):9. PMC: 5669619. DOI: 10.1007/s11892-017-0840-0. View

12.

Knowler W, Barrett-Connor E, Fowler S, Hamman R, Lachin J, Walker E . Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. N Engl J Med. 2002; 346(6):393-403. PMC: 1370926. DOI: 10.1056/NEJMoa012512. View

13.

Geiss L, James C, Gregg E, Albright A, Williamson D, Cowie C . Diabetes risk reduction behaviors among U.S. adults with prediabetes. Am J Prev Med. 2010; 38(4):403-9. DOI: 10.1016/j.amepre.2009.12.029. View

14.

Ely E, Gruss S, Luman E, Gregg E, Ali M, Nhim K . A National Effort to Prevent Type 2 Diabetes: Participant-Level Evaluation of CDC's National Diabetes Prevention Program. Diabetes Care. 2017; 40(10):1331-1341. PMC: 5606310. DOI: 10.2337/dc16-2099. View

15.

Zou G . A modified poisson regression approach to prospective studies with binary data. Am J Epidemiol. 2004; 159(7):702-6. DOI: 10.1093/aje/kwh090. View

16.

Ackermann R, Marrero D . Adapting the Diabetes Prevention Program lifestyle intervention for delivery in the community: the YMCA model. Diabetes Educ. 2007; 33(1):69, 74-5, 77-8. DOI: 10.1177/0145721706297743. View

17.

Sepah S, Jiang L, Peters A . Translating the Diabetes Prevention Program into an Online Social Network: Validation against CDC Standards. Diabetes Educ. 2014; 40(4):435-443. DOI: 10.1177/0145721714531339. View